5.  The applicant was born in 1982 and lived in Kaliningrad until his arrest.
6.  On 18 May 2006 the applicant was arrested on suspicion of murder. On 28 November 2006 the Kaliningrad Leningradskiy District Court found him guilty of murder and attempted murder and sentenced him to thirteen years’ imprisonment, to be served in a correctional facility operating under a strict regime. With the judgment becoming final, the applicant was sent to a correctional colony in the Kaliningrad Region.
7.  The parties provided the Court with handwritten and typed versions of the applicant’s medical records, showing the history of the diagnosis and development of the applicant’s HIV and hepatitis infections, as well as a number of reports assessing the current state of his health. In particular, as is noted in a medical certificate from the Kaliningrad Regional Infectious Diseases Hospital, in December 2005 the applicant underwent testing in a drug clinic, where, in view of his being a drug addict, his blood was taken for testing for hepatitis C and HIV infection. The applicant tested positive for the presence of both viruses. The final diagnosis made on 23 March 2006 in the AIDS Centre where the applicant had sought assistance following the testing was: clinical stage 3 HIV infection, chronic viral hepatitis C with minimal activity, opiate drug addiction. The applicant continued being monitored by the medical staff of the AIDS Centre, with the most recent consultation taking place on 17 April 2006 when the applicant sought the assistance of a psychiatrist. He also gave a blood sample, which was tested for hepatitis B.
8.  Following the applicant’s admission to detention facility no. 1 on 20 May 2006, a sample of the applicant’s blood was taken for testing to establish the presence of any blood-borne infections. The results of the tests confirmed the diagnosis established by the AIDS Centre. On 14 December 2006 the applicant was transferred to detention facility no. 4, which copied the results of the previous testing into the applicant’s medical records. Tests performed in January 2007 showed the slight progress of the HIV infection. As is evident from the applicant’s medical records, in April 2007 he was advised to consider the possibility of antiretroviral therapy. The applicant asked to postpone the issue until he had met with his mother. Several days later the head of the medical unit authorised the applicant’s transfer to a correctional colony, having considered him fit for the transfer.
9.  On arrival at correctional colony no. 13, the applicant immediately expressed his willingness to commence HIV treatment. That request was recorded in his medical records, but the treatment was not initiated. Tests performed in July and August 2007 confirmed the further progress of the HIV infection and elevated liver enzymes. In particular, the tests showed a drop in the CD4 cell count below 498 cells/mm3. It was recommended that the tests be repeated in three months.
10.  In the beginning of October 2007 the applicant started complaining of a severe pain in the throat, coughing, dizziness, fatigue and fever. Having been diagnosed with an acute respiratory disease, prison doctors prescribed a number of medicines and bed rest. In the following weeks the applicant’s complaints intensified. While the typed version of the applicant’s medical records states that he was subjected to another CD4 cell count test on 25 November 2007, the Court was unable to find records of that test in the handwritten version. From the material available to the Court, it appears that the results of the testing appeared in the typed version by mistake, as they duplicated the results of the CD4 test performed exactly a year later, on 25 November 2008 (see below).
11.  The applicant continued complaining of a deterioration of his health, having been diagnosed with “localised lymphadenopathy [in the inguinal area] against a background of HIV infection”. No treatment was required. The applicant’s subsequent complaints, related to an acute respiratory infection and dermatological problems, were promptly and effectively addressed by the medical personnel.
12.  Subsequent immunological testing in March 2008 revealed a serious decrease in the CD4 cell count to approximately 290 cells/mm3. The attending physician recommended the commencement of antiretroviral therapy. On 18 April 2008 the applicant commenced the therapy, comprising two medicines: Combivir, a fixed dose combination of the drugs lamivudine (Epivir) and zidovudine (Retrovir), and Stocrin. The drugs were to be taken daily in accordance with a strict schedule to avoid drug resistance. The requirement of strict adherence to the chemotherapy regimen was recorded in the medical report. The applicant was also assigned bed rest.
13.  Having continued suffering from dermatological problems and inflammation of an inguinal gland, the applicant received treatment. The recommendation of bed rest was extended until the middle of June 2008.
14.  Although the medical records show that the applicant continued receiving the antiretroviral therapy without any interruptions, another immunological test in July 2008 revealed a drop in his CD4 cell count to below 240 cells/mm3. The antiretroviral therapy continued without any amendments being made.
15.  On 25 November 2008 the applicant complained of a loss of appetite, dizziness, and nausea. He was diagnosed with biliary dyskinesia and admitted to the colony medical unit for inpatient treatment. His blood was also taken, with the tests showing a very serious decrease in CD4 cell count. The diagnosis indicated in the medical records was as follows: biliary dyskinesia, clinical stage 4 HIV infection (B2), progressing chronic hepatitis. The applicant was recommended to continue with the same regimen of antiretroviral therapy.
16.  Further tests, including a CD4 cell count and plasma viral load, were performed towards the end of February 2009, and showed a slight improvement in the applicant’s condition.
17.  The applicant continued receiving the same antiretroviral therapy comprised of two drugs. However, in May 2009 the colony medical staff asked for the applicant’s assessment in the AIDS Centre, with a view to changing his chemotherapy regimen. The new recommendations received from the AIDS Centre towards the end of August 2009 provided for a new regimen to be followed comprising Epivir, Zerit and Kaletra. With another round of immunological testing showing a slight deterioration of his condition, the applicant immediately started receiving the newly composed therapy.
18.  No negative changes were identified in the applicant’s immunological status between September 2009 and February 2010. The concomitant health problems pertaining to the applicant’s condition were promptly flagged and duly addressed.
19.  On 10 March 2010 the applicant was transferred to correctional colony no. 9. Upon his arrival there, a colony doctor issued the following diagnosis: progressing HIV infection in the progressing stage, chronic hepatitis with minimum activity, heroin drug addiction, [possible] polyarthritis. The doctor confirmed that the applicant continued to receive the antiretroviral therapy comprising three drugs and prescribed another medicine. The applicant was assigned bed rest and was checked on by colony doctors several times a week. Immunological and clinical tests performed in April 2010 did not show any negative changes in the applicant’s condition. The colony medical staff continued addressing his multiple complaints, including those which related to his psychological state. They promptly responded to any complaints which related to the side-effects of the antiretroviral therapy, subjected the applicant to additional testing, called an infectious diseases specialist to attend on him and adjusted his drug therapy.
20.  On 15 April 2010 a medical expert panel declared that the applicant was category 3 disabled.
21.  In June 2010 the applicant was sent to the regional prison hospital for an in-depth examination and a possible correction of the therapy regimen. The applicant’s diagnosis on admission to the hospital was: HIV infection, progressing against a background of antiretroviral therapy, the presence of secondary illnesses, chronic hepatitis with acute episodes, chronic bronchitis with acute episodes, polyneuropathy with generalised pain in the wrist and ankle joints, and heroin addiction. Having stayed in the hospital for more than a month, the applicant was released in a satisfactory condition for active supervision by the colony medical personnel. The recommendation to continue with the antiretroviral therapy and hepatoprotectors was maintained.
22.  Tests performed in August 2010 showed a significant rise in the applicant’s CD4 cell count to above 342 cell/mm3. At the same time, the tests revealed a very high viral load.
23.  Between August and October 2010 the colony personnel afforded the applicant the usual level of medical attention, responding to his health complaints pertaining to secondary illnesses, authorising additional clinical tests and continuing to maintain the antiretroviral therapy throughout.
24.  On 14 October 2010 the applicant was transferred to a prison hospital in colony no. 8. His diagnosis on admission recorded the further progress of the HIV infection to clinical stage 4. Hospital doctors noted that the first task on the agenda was the correction of the applicant’s antiretroviral therapy, given the progress of the infection. A large number of tests were carried out in the hospital, including those which aimed at treating the applicant’s secondary illnesses. His chemotherapy regimen was expanded to include additional antiviral medicines, hepatoprotectors, vitamins, muscle relaxants, and so on. Having considered that the applicant’s condition had stabilised, he was sent back to the correctional colony on 25 November 2010. The records state that he was provided with the necessary amount of antiretroviral drugs to cover the period of his transfer back to the colony.
25.  Another set of immunological testing in January 2011 revealed a slight drop in the applicant’s CD4 cell count but a significant decrease of the viral load at the same time.
26.  Between January and April 2011 the applicant was regularly examined by a number of doctors, including an infectious diseases specialist, a surgeon, a dermatologist, a neurologist, a psychiatrist, and a general physician. The recommendations of those specialists were closely followed through. Clinical and immunological assessments were performed at regular intervals. Given the results of the medical examinations and immunological monitoring, the applicant’s condition was considered stable. The doctors also noted that the applicant had a good body mass index score.
27.  In April 2011 the applicant was transferred to the prison hospital in correctional colony no. 8, where he has remained ever since. The medical records provided by the Government indicate that the applicant has been receiving antiretroviral therapy. His drug regimen has been adjusted to take account of his health complaints and the results of regular and extensive clinical, radiological and immunological monitoring. The hospital personnel examine the applicant at least once every three days. Specialists from the AIDS Centre have been invited to assess the applicant in order to determine possible amendments to the antiretroviral therapy. The recommendations of those specialists have been complied with. On 28 March 2012 a forensic medical panel determined that the applicant was category 2 disabled. As is clear from the most recent records dating from April 2012, while certain negative changes in the applicant’s condition have been registered on a number of occasions during his stay in the hospital, they were dealt with and have been overcome. The applicant’s condition is stable.
28.  On 24 June 2011 a medical panel of the prison hospital issued report no. 39-11, recommending the applicant’s release on health grounds in line with paragraph 39 of the List of Illnesses Warranting Relief from a Sentence, adopted by a decree of the Government of the Russian Federation on 6 February 2004 (hereinafter – “the List”). The medical panel stressed that the applicant’s diagnosis of “progressing HIV infection at clinical stage 4, despite antiretroviral therapy [being] administered; the presence of secondary illnesses which are mainly affecting the central nervous system in the form of encephalopathy and polyneuropathy; chronic hepatitis C and B with acute episodes; accompanying illnesses: chronic bronchitis, bacterial dermatitis on the face, and fungal lesions on the feet” warranted his release.
29.  Acting in line with the recommendations of the medical panel, the correctional colony’s governor filed an application with the Kaliningrad Tsentralniy District Court seeking the applicant’s release. The applicant supported the application, having also argued that he had not been receiving the necessary medical attention in detention, including for his HIV infection.
30.  On 8 August 2011 the District Court held a hearing, during which the applicant’s attending doctor stated that the hospital was capable of providing the necessary medical assistance, as it had the necessary resources and specialists. However, the doctor was concerned that there was no legal basis for permanently keeping the applicant in the hospital, although he was in need of complex medical care. The doctor also confirmed that the applicant was aggressive, that his behaviour was poorly controlled and that he frequently acted irrationally, with the result that he had been placed under ongoing psychiatric and neurologic assessment.
31.  On the same date the District Court dismissed the application for release, having found as follows:
“By virtue of Article 81 § 2 of the Russian Criminal Code a person who, after having committed a crime, contracts a serious illness which precludes his serving a sentence may be released by a court from further punishment.
As noted in report no. 39-11 of the special medical panel of [the prison hospital in correctional colony no. 8] in the Kaliningrad Region, following an examination on 24 June 2011 [the applicant] was diagnosed with progressing HIV infection at clinical stage 4, despite antiretroviral therapy [being] administered; the presence of secondary illnesses which are mainly affecting the central nervous system in the form of encephalopathy and polyneuropathy; chronic hepatitis C and B with acute episodes; accompanying illnesses: chronic bronchitis, bacterial dermatitis on the face, fungal lesions on the feet. According to the same report by the medical panel ... [the applicant] should be granted relief from the sentence in line with paragraph 39 of the List.
At the same time, [while] relief from a sentence in view of an illness is a right [... it is] not [one which gives rise to] an obligation on a court dealing with that issue; the court takes into account not only the presence of the illness included on [the List], but also the manner in which the illness precludes the detainee from serving a sentence, the nature and degree of social dangerousness of the crime, the detainee’s ability to improve, his behaviour while serving his sentence, his having a permanent place of residence, close relatives who may wish to take care of the detainee, the term of imprisonment which has already been served and the personal characteristics of the detainee.
In the course of the court proceedings it was established that [the applicant] had committed a particularly serious criminal offence and that he had served less than half of the term of his sentence. [The applicant] has been negatively characterised [by officials] during ... his detention; he has violated the prison rules on a number of occasions, having received thirty-four penalties which have not yet expired. On 15 July 2009 he was declared a “persistent offender” of the established prison rules and was registered as a person prone to provocative behaviour. Having studied those violations, the court considers that they have a persistent character.
According to explanations by doctor K., [the applicant] behaves inadequately and aggressively towards those around him; he does not control his behaviour.
Those circumstances make it impossible for the court to conclude that the applicant has [taken the first] step on the path of improvement; the particular features of his behaviour at the present time do not exclude the possibility of his committing other criminal offences, if he were to be released in view of his illness, thus presenting a danger to others.
The court also takes into account that there are special medical facilities within the prison system; those facilities can accommodate sick persons, including those who present an extreme danger to society when there are grounds to believe that the person, if released, may commit another crime.
As was established, [the applicant] is undergoing inpatient treatment in [the prison hospital in correctional colony no. 8]... where he is receiving the necessary treatment free of charge. That hospital employs an infectious diseases specialist and a neurologist.
[The applicant’s mother] also explained that she intends to help her son to pay for medicines when he requires inpatient treatment.
The court finds that if released [the applicant] will not be able to receive the necessary assistance. Moreover, the opportunity to be admitted to an infectious diseases hospital depends on the availability of places; [in the prison hospital] [the applicant] can receive treatment similar to that which he could receive in an infectious diseases hospital.”
32.  On 4 October 2011 the Kaliningrad Regional Court upheld the decision of 8 August 2011, giving full support to the District Court’s findings.
33.  In 2011 the applicant lodged an action with the Kaliningrad Tsentralniy District Court, seeking compensation for damage caused by the poor conditions of his detention for seven days in 2002.
34.  On 25 March 2011 the District Court partly accepted the claim, awarding the applicant 2,000 Russian roubles (RUB) in compensation. The judgment became final on 20 July 2011, when the Kaliningrad Regional Court upheld it on appeal.
35.  In another set of proceedings, the District Court accepted another claim from the applicant regarding his detention for three days in a punishment cell in a temporary detention facility in 2007 and awarded him RUB 3,000. That judgment was also upheld on appeal.